Hormones Flashcards
What are the four hormone therapies
- thyroid disease
- menopausal hormone therapy
- contraception
- selective estrogen receptor modulators (SERMS)
The thyroid gland governs tissue metabolism. What are the two major thyroid hormones
- triiodothyronine (T3)
2. thyroxine (T4)
Which type of thyroidism causes bradycardia, poor cold resistance, and mental/physical slowing and is associated with low hormone levels
hypothyroidism
which type of thyroidism cause tachycardia, body wasting, tremor, nervousness, and heat flashes
hyperthyroidism
what are the 3 drugs used to treat hypothyroidism
- levothyroxine
- levothroid
- liothyronine
what are the drugs used to treat hyperthyroidism
- propylthiouracil
2. methimazole
what is the #2 highest selling drug in america
levothyroxine sodium (synthroid)
which two drugs inhibit the first conversion step and the production of the hormone
propylthiouracil and methimazole
what is the MOA of levothyroxine
synthetic T4
what are common AE of levothyroxine
- weight loss
- diaphoresis (sweating a lot)
- headache
- alopecia
- hypertension
- pseudotumor cerebri aka intracranial hypertension –> kids can be seen with swollen optic nerves
what are ocular SE of levothyroxine
myasthenia gravis like symptoms: ptosis, diplopia, EOM paresis
what are drug interactions of levothyroxine
- sympathomimetics are additive
2. sympatholytics are antagonistic
what is the most potent estrogen produced and secreted by the ovary? what is the primary circulating estrogen after menopause?
estradiol; estrone (metabolite of estradiol)
what are the 4 therapies used in menopause
- estrone
- estradiol
- estrogen
- mestranol
what is the indication of estrone
- menopause
- breast cancer
- prostate cancer
- osteoporosis prevention
what is the MOA of estrone
binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems
what are common AE of estrone
- headache/migraine
- elevated BP
- weight changes
- fluid retention
- contact lens intolerance (impt!)
- vision changes
What are black box warnings for estrone
- endometrial cancer
- invasive breast cancer
- stroke
- DVT
- MI
what are drug interactions of estrone
- azole antifungals (impaired metabolism)
- adverse effects of systemic steroids may be increased
- anti hyperlipidemic effects of omega 3 FA’s may be antagonized. –> LDL levels are increased.
what are contraindications of estrone
- hypertension
- smoker
- migraine with aura > without aura
What are the drugs/therapies used for contraception
- drospirenone/ethinyl estradiol (YAZ)
- norgestimate-thinyl estradiol
- norethindrone- ethinyl estradiol
- medroxyprogesterone (progesterone)
how is grouping of the contraceptions done?
by activity profile vs progesterone alone:
- monophasic
- biphasic
- triphasic
- four phasic
what is the indication for Yaz
- contraception
- acne vulgaris
- dysmenorrhea
- endometriosis
- PCOS
what is the MOA of Yaz
suppresses LH and FSH; inhibiting ovulation; alters cervical mucus and endometrium.
what are common AE of Yaz
- headache
- weight changes
- BP elevated
- increased cholesterol
- contact lens intolerance
what are severe AE of Yaz
- MI
- Stroke
- ocular lesions
what is the BB warning for Yaz
- smoking
2. CV events
What are drug interactions with Yaz
- impaired metabolism of cyclosporine
- NSAIDs: additive hyperkalemia
- Tetracyclines, Penicillins, cephalosporins, macrolides, and quinolones: decreased efficacy
- ascorbic acid (vitamin C): decreased metabolism
what are contraindications of Yaz
- hypertension
- smoker
- migraine with aura > without aura
What is the selective property of SERMS and what is their use?
refers to their ability to inhibit or stimulate estrogen receptors depending on the tissue. Uses include management of breast cancer, osteoporosis, menopause and anovulation (infertile woman)
what is the most common SERM
tamoxifen
what is the indication of tamoxifen
metastatic breast cancer
what is the MOA of tamoxifen
binds to estrogen receptors, producing estrogenic and anti estrogenic effects
what are common AE of tamoxifen
- dizziness
- headache
- VA changes
what are severe AE of tamoxifen
- thromboembolism, stroke
- pancytopenia (declined cells in our body that are routinely replaced in our body)
- retinopathy, cataracts (impt!)
what are drug interactions of tamoxifen
- may increase cyclosporine, systematic steroid, oxycodone levels
- chlorpheniramine (OTC AH), macrolides - inhibits hepatic production of active metabolite
